CHRONIC STRESS AND THE HPA AXIS
Stress Is The Number #1 Killer In The World
It costs the USA over $1 TRILLION dollars a year, and as the U.C. Irvine Center for Occupational & Environmental Health found, Over $400 Billion is Spent on Stress-Related Treatments Every Year. But the medical world has made a mess out of finding simple solutions. Drugs just dull the pain. Therapy is expensive. And health spas only make us feel good and happy for a day. And yet millions of people will spend millions of dollars on the “latest” cure for unhappiness.
Here is a 2011 “Stress In America” survey by the American Psychological Association that shows the strong link between stress and our health.
Just How Bad Is Your Stress — Really?
The Centers for Disease Control reports stress is the leading factor in illness and 5 out of the 6 leading causes of death — Heart Disease, Cancer, Stroke, Lower Respiratory Disease, even Accidents
Even age-related problems are directly affected by stress. By using NeuroWisdom 101, the research shows that Alzheimer’s, Parkinson’s, and Dementia can be significantly slowed down. “Every worrisome thought damages thousands of neurons in your brain, and few people are aware of how many negative thoughts and feelings they have every hour.”
The United Nations Calls Stress “The 21st-Century Health Epidemic.”
After studying hundreds of people for 30 years Duke University Found Negativity Takes AWAY Two Years Away From Your Life and Dramatically Lowers Your Life-Satisfaction. NeuroWisdom 101 is specifically designed to transform negativity into optimism — The Mayo Clinic Discovered THIS Approach ADDS Two Years To Your Life!
The American Institute of Stress Estimates “75% – 90% Of All Visits To Primary Care Physicians Are For Stress Related Problems.”
Stress is a key contributor to disease and illness. This is no longer just a matter of opinion, but has been supported by science. The management of stress is essential to optimal health. For most people, life is busy. In fact, often too busy! At work and at home, people find themselves dealing with too many obligations, projects, tasks and chores that all need attention, now! Having too many things to do leads to plenty of daily stress. For many, that chronic stress becomes an issue when it leads to symptoms like fatigue, brain fog, low libido, dry skin, disease, cancer and more.
The human reaction to stress is designed as a survival mechanism for the body. It is a complex cascade of hormonal interactions that exert a profound effect on many physiological systems to help protect us from internal (illness) or external (sabre-toothed tiger) danger.
Unfortunately, in today’s world, rather than a single fight-or-flight episode, such as running from a dangerous animal, our body is faced with a multitude of smaller but more chronic stressors such as unstable blood sugar levels, less than eight hours of sleep, bad traffic or excessive workload. We also suffer from perceived stress, our mental interpretation of an event, such as a wedding, which causes identical stimulation to our nervous system without ever truly being “dangerous.”
Despite man’s many advances, our neurochemical and hormonal reactions to stress (the Hypothalamic-Pituitary-Adrenal, or HPA, axis) have not changed greatly since our caveman days. Designed for acute stressors that resolve rapidly, our present-day, chronic, low-grade stress results in the continual release of corticotropin-releasing hormone (CRH) from the hypothalamus, that area in the lowest region of the forebrain primarily concerned with survival.
This chronic secretion causes dysfunction in the HPA axis, desensitizing the hypothalamic and pituitary receptors to negative feedback from adrenaline, noradrenaline and, particularly, cortisol.
In this state, the hypothalamus also loses its ability to coordinate incoming information from the areas that control emotional behaviour, motivation and control of the internal and external environment – the limbic system, reticular areas, thalamus, amygdala and hippocampus. This loss of control creates exaggerated neurochemical, emotional and physical responses within the sympathetic nervous system (SNS) exacerbating HPA dysregulation.
What Is The Effect Of This?
Loss of negative feedback within the neuro-hormonal system creates a multitude of ailments and diseases. It increases the production of antidiuretic hormone (ADH), aldosterone and angiotensin, increasing vascular vasoconstriction and sodium retention. It increases C-reactive protein and endothelin, promoting atherosclerosis and inflammation. It directly increases low-density lipoprotein (LDL) production as well as glucocorticoid and mineralocorticoid release, further increasing cardiac risk.
Cortisol inhibits gonadotropin-releasing hormone (GnRH) and increases gonadotropin-inhibitory hormone (GnIH, an inhibitory hormone that directly reduces GnRH release in the dorsal medial hypothalamus). Both effects reduce follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol and testosterone production, thereby impairing fertility. In addition it elevates prolactin in the non-pregnant female, inflames the uterus and causes fallopian tube spasm that can crush the egg en route to implantation.
Stress has a direct impact on inflammatory bowel diseases. It increases the release of neurotensin, the gastrointestinal neuropeptide that alters NF-B-dependent interleukin-8 (IL-8) expression in colonocytes, causing inflammation and disrupting healing in the bowel. It also stimulates histamine release from the mast cells and immunoglobulin G (IgG) production to non-specific foods causing bloating, inflammation and mucous production.
Stress reduces tumour necrosis factors (TNF) and natural killer (NK) cells, turns on viral-induced cancers such as sarcomas and lymphomas and directly alters DNA repair and cellular growth to increase cancer and metastasis risk. In fact, by blocking stress hormones, metastasis can be reduced by up to 300 per cent.
Stress contributes to one of the most dangerous and growing conditions in North America, namely, obesity. In a society where 65 percent of people are overweight and 31 per cent are clinically obese, chronic stimulation of the HPA axis can be viewed as one of the most dangerous risk factors for our health. Cortisol inhibits the release of leptin, the hormone that reduces our appetite after a meal, and “jump-starts” your metabolism.
It also increases the release of insulin in response to carbohydrate load, promoting fat storage, particularly in the abdominal region where white fat cells have three times the number of cortisol receptors on their surface. To make matters worse CRH and cortisol block the production and binding of both serotonin and dopamine. This combination of imbalanced hormones destabilizes mood and stimulates food cravings.
Stress, via cortisol, also increases the physical craving for carbohydrates. Cortisol production triggers the release of a brain chemical called neuropeptide Y, which causes the desire for carbohydrate consumption. This biochemical mechanism is the reason that many people overeat sweets and starchy foods when they are under stress.
* 79%-90% of all visits to health care practitioners in North America are due to stress-related illnesses or complaints.
* 1 million North Americans are absent on any given workday due to stress and stress-related disorders
* 60% of absences at work are the result of stress
* According to an article published in January 2015 in Forbes Magazine, workplace stress causes additional expenditure of up to $190 billion of U.S. healthcare annual costs. The biggest factor of these costs stems from modern stressful and demanding work.
Chronic stress reduces brain-derived neurotrophic factor (BDNF) in the hippocampus and prefrontal cortex and increases neuroinflammation, an alteration noted in the formation of depression.
Furthermore, chronic stress induces prolonged periods of glutamate release in the hippocampus and decreases the ability to clear extracellular glutamate. These alterations in the glutamate transmission may be related to the impairments in the spatial and contextual memory performance and stress-associated psychiatric disorders, including mood and anxiety.
The medical community first used the term burnout to refer to physicians whose demanding, long-term shifts created dramatic, acute stress. Any worker, however, can suffer from this condition. The American Institute of Stress defines burnout as “a disabling reaction to stress on the job.” The institute also estimates that job stress costs U.S. industry $300 billion annually, as measured by absenteeism, decreased productivity, employee turnover, and direct medical, legal, and insurance fees. The institute also reports that nearly half of all American workers suffer from symptoms of burnout. In healthcare workers the prevalence of PTSD has become an increasing concern.
Consider, also, the following statistics from the National Institute for Occupational Safety and Health, part of the Centers for Disease Control and Prevention:
- One-fourth of employees view their jobs as the number-one stressor in their lives. (Source: Northwestern National Life survey)
- Three-fourths of employees believe today’s workers have more on-the-job stress than employees a generation ago. (Source: Princeton Survey Research Associates)
- Work-related problems are more strongly associated with health complaints than are any other life stressor—more so than even financial problems or family problems. (Source: St. Paul Fire and Marine Insurance Co.)
What Is The HPA Axis?
The HPA Axis is part of the endocrine system. It consists of the hypothalamus, the pituitary gland and the adrenal glands. The HPA axis creates the stress response in the body, when a person encounters any type of stress in their daily life, no matter how big or small.
The HPA Axis works as a feedback loop. This occurs when the output of one of the glands loops around and becomes input for another gland. When receptors in the hypothalamus and pituitary receive signals from the adrenals that high levels of cortisol have been produced it triggers the hypothalamus and pituitary to stop production of Corticotropin Releasing Hormone (CRH) and Adrenocorticotropic Hormone (ACTH). It then signals the adrenals to reduce production of Cortisol. Once Cortisol levels begin to decrease, the stress response stops, the body calms down and hormone levels to return to normal. This is a negative feedback loop that is well functioning in healthy individuals.
But dysfunction occurs, as the result of chronic stress. When chronic stress occurs in an individual, the HPA axis continues to release hormones on an accelerated basis.
**But after time, the overproduction of these hormones leaves the glands of the HPA axis desensitized and they stop recognizing signals to stop producing hormones. The negative feedback loop is no longer functioning as it should and HPA axis dysfunction becomes the norm.
Specific patterns of a dysregulation of the HPA axis and Glucocorticoid Receptor (GR) function are found in different stress-related psychiatric entities e.g. major depression, job-related exhaustion or posttraumatic stress disorder. GR challenge tests like the dexamethasone-suppression test (DST), the dexamethasone-corticotropin-releasing hormone (dex-CRH) test or most recently the analysis of the dexamethasone-induced gene expression are employed to sensitively measure HPA axis activity in these disorders.
Published studies on the glucocorticoid receptors and chronic stress:
(1) Glucocorticoid regulation of inflammation and its behavioral and metabolic correlates: from HPA axis to glucocorticoid receptor dysfunction
(2) Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk
So how does this affect health?
There are many symptoms that result from HPA axis dysfunction.
These are the most common symptoms that people deal with:
Blood pressure problems
Lowered immune system
Blood sugar problems
Increase in abdominal fat
Fatigue, particularly during the morning and mid-afternoon
Slow wound healing
Cravings for salt or salty foods
Poor muscle tone
Anxiety and Depression
Allergies and Asthma
Irritable Bowel Syndrome
Chronic Fatigue Syndrome
Post Traumatic Stress Disorder
These symptoms will get worse over time if left unchecked.
Acute or chronic stress often precedes psychiatric disorders and it has been shown that patients suffering from affective disorders have a dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis (Owens and Nemeroff, 1991). The HPA-axis is activated during stress leading to elevated plasma levels of cortisol. For an effective response to stress, activation of the HPA-axis has to be followed by deactivation. In some conditions, however, the subject may have increased and/or prolonged activation of the HPA-axis due to an absent switch off of the HPA-axis to normal state. When the HPA-axis remains in a state of overactivity, it will lead to negative effects.
In depressed patients, for example, the negative feedback of cortisol on the hypothalamus and pituitary gland is disrupted and concentrations of corticotropin-releasing hormone (CRH), ACTH, and cortisol remain elevated in the absence of the preceding stress factor (Holsboer, 2001). Allopregnanolone attenuates CRH-release and CRH-gene expression (Patchev et al., 1994) and also also decreases ACTH concentrations (Patchev et al., 1996).
Vice versa, administration of CRH increases allopregnanolone concentrations (Genazzani et al., 1998). Taken into account that allopregnanolone plasma levels increase following acute stress, it is thought that allopregnanolone is formed as a calming compensatory response to stress. The role of allopregnanolone in stress linked psychiatric disorders like depression deserves therefore further attention.
Read about the Biochemical Consequences of Stress here
REDUCING STRESS IN YOUR LIFE
Try one or all of these methods and find the combination that works best for you.
1. Myofascial Release
Freeing Emotions and Energy subscribes to the Rolfing founder Ida Rolf’s principle, “When gravity gets flowing appropriately through the body, then the body spontaneously heals itself.” Fascia, the sheath-like connective tissue network that surrounds our muscles, is a communications system that connects all the body’s tissues. This tissue stores our energetic slowdowns and physical reactions, so we need to dislodge embedded thought patterns to release the stored tension.
Find an Occupational, Physical, Massage or other Therapist who is trained in myofascial release and get an appointment with them to see to it that your fascia is release of all tension and trigger points. You will be amazed at how much trapped tension and stress is in your body and how much better you feel once it is gone.
FIND A THERAPIST:
If you’ve had a lot of early life stress or trauma in your life the Somatic Experiencing® Trauma Institute and Bodywork and Somatic Education™ (BASE™) has excellent therapists who can help heal you.
The Psoas muscle holds all our trapped emotions and traumas so it’s vital to get it released and freed up.
Turns out the psoas is an incredibly unique muscle. It’s the only muscle that connects the spine to the femur bones. Superficially, the psoas originates at the 12th thoracic vertebrae body and the disks between vertebrae, it continues down the lumbar spine, passing over the ilium and inserting into the lesser trochanter on the inside of the femur bone. Pulling on the psoas from this origin point creates flexion of the spine, drawing it toward the pelvis. This occurs because the origins and pull are coming from the front of the vertabrae’s center of rotation. More deeply, the psoas has origins at the transverse processes of the spine. Pulling the psoas from this origin point creates extension because the pull comes from behind the vertebrae’s center of rotation. The two muscles are antagonists and work together to increase compression of the vertebra, stabilizing the spine, in addition to flexion of the pelvis and femurs. The psoas allows us to lift our legs toward our pelvis; and also enables us to bend forward at the waist bringing our pelvis toward the legs.
A short, tight psoas can lead to low back pain, sacro-iliac pain, sciatica, and a host of other issues. It also constricts organs and breath. And releasing the psoas often brings up old emotions that were stored deep in the tissues.
2. Sleep better
Get good sleep as a #1 strategy by starting out with writing out worries, fears, and frustrations. This is a cathartic practice and can be used during the night-time routine as a way to clear your mind of the things that normally prevent you from resting. Try including a relaxing bath, a cup of chamomile tea, and a good book in your routine and give yourself a good hour or more to unwind before trying to sleep.
3. Remove stress factors
This may occur as a natural progression once you implement several of these steps. Instead of dwelling on what you can’t change, focus on what you can. You may need to be intentional by evaluating all the possible stress factors in your life and focus on removing the ones that you can control. From healthier food choices to keeping openings in your schedule for down time, a proactive approach is your best chance for success.
4. Medications in moderation
Use as needed until other strategies are in place. Ideally you will want to get to a place where you don’t require medication to help you sleep. However, while you are beginning your new routine, prescription or OTC drugs may help in the interim. Consult your doctor before stopping any medications and share your desire to learn to sleep and cope with stress on your own in time.
5. Write or talk it out
Practice expressive writing (journaling) or speak to a counselor or support group. Both allow you to write or talk out your feelings in a safe environment. The practice of writing out negative feelings is extremely therapeutic, especially if you are unable to address the issue directly, such as in a work situation or relationship you can’t avoid.
6. Back and spine support
Promote spine health and flexibility by practicing good posture, taking a yoga class, or seeking the corrective care of a chiropractor or physical therapist for additional guidance. Once your nervous system is thriving and flowing at maximum capacity, stress can become easier to manage.
7. Prayer and meditation
We are spiritual beings who respond to life on a spiritual and physical level. Ignoring the spiritual (emotional) aspect of our lives – good and bad – impacts our physical bodies and our mind’s ability to process stress. Whether it’s listening to relaxing music, or practicing relaxation through prayer or meditation, take the time to shut out the demands of the world around you, breathe deeply, release tension, and enjoy the benefits of slowing down.
8. Connect with nature
Dr. Mercola discusses the stress-reducing benefits of gardening in his article A Simple Way to Reduce Stress. Other easy methods include walking or hiking through your favorite nature spot, visiting a botanical gardens, or leaving devices inside and sitting in your yard or patio for a set amount of time.
9. Think positive!
Positive thinking releases serotonin, which in turn, lowers pain perceptions. Speak aloud all the good things in your life and be thankful for even the little things. Focus on what you do have instead of what you don’t, and you’ll be surprised at how quickly your mood will change.
10. Increase your fun
When you work hard, you need to play harder! Start a hobby, get together with friends for a game night, watch your favorite movie, take a drive or go for a walk without any specific destination and enjoy being in the moment.
11. Nutrition and supplementation
To maximize your body’s resources and minimize the effects of processed foods, additives, and your environment, eat wholesome foods and supplement where needed to support your body’s ability to combat stress. Getting your hormones to optimal levels will help greatly on combating the effects of stress.
12. Brainwave Entrainment, Biofeedback, Cranial Electrotherapy Stimulation and Neurofeedback
Brainwave Entrainment, Biofeedback, Cranial Electrotherapy Stimulation and Neurofeedback all are great therapies that help calm the brain and the HPA axis. (*)
Heart disease patients who learn how to manage their stress with relaxation and biofeedback are 77% less likely to have a heart attack or require cardiac surgery than patients who receive only standard medical care.
Exercise can be an effective component of a stress management program, and all types of exercise can be beneficial for stress management. Exercise programs consistent with the current recommendations to improve health can be prescribed to manage stress. Fitness professionals should recognize that it might be necessary to refer a client to a psychologist or other health care provider to help develop strategies for managing stressors that produce chronic and acute episodic stress. (*)
Yoga has an effective role in reducing stress, anxiety, and depression. Thus, it can be used as complementary medicine.